Bariatric Ulcers

Listen to your body. Eating or drinking should never hurt or burn but too many post ops tolerate low level discomfort because they don’t realize that they have a bariatric ulcer. Anyone who has had bariatric surgery has the potential for stomach ulcer, which begin as a tiny sore or even just inflammation, normally where the pouch or intestines have been stitched or stapled. This is not the H. pylori bacterial ulcers some have as pre-ops. Without diagnosis and treatment, the sore gets larger, deeper and can even eat all the way through the stomach wall and cause big trouble. You may have this condition if you notice stomach pain and burning, especially after eating or drinking. It may occur in new post ops or old post ops.

When you get help early, this problem is easily treatable without scary or invasive procedures. All it takes is a bottle of liquid called Carafate, by prescription. It comes in tablets too and while ‘easier’ to take, specialists advise that the oral suspension (medical speak for liquid) is better at coverage. Too often bariatric post ops struggle for long periods of time with pouch ulcers and it is often due to not taking Carafate properly.

Our BE Administrator took Carafate twice and had symptoms come back yet again before she read the tiny microprint on the accordion fold out stuck to the bottle and discovered she was taking it all wrong. The doctor handed her the script and she thought it was to take like ‘Pepto’. Nope!

Not to scare you if you do have a pouch ulcer (trying to snap your rubber band to get your attention though) but this is one of those problems that can suddenly go bad once these sores get very deep or very large and you may need surgery – which is why it is important to take the easier route of consuming the medication the right way and for the entire time, the first time.

Sometimes we just need a common sense discussion the HOW AND WHY of issues we face after bariatric surgery. This is one problem that can needlessly take people a very long time to get over.

IF YOUR DOCTOR PRESCRIBES CARAFATE PLEASE TAKE IT PROPERLY. Here are some tips…
– Follow the dosing schedule, which is usually every 6 hours.
– Take it on an empty stomach.
– Carafate is a NOT a product where you take a swig for a flare up, such as you would take Peptol Bismol.
– YOU NEED TO TAKE CARAFATE FOR 8 WEEKS, JUST AS THE INSTRUCTIONS SAY.
– Do not stop taking it as soon as you feel “better”, to fully heal the sores you need to take it for the full 8 weeks IN A ROW.
– If you do not take it 1 hour before eating when stomach pouch is empty, IT WILL NOT WORK.
– If you do not wait 2 hours after eating to take it when stomach pouch is empty, IT WILL NOT WORK.
– Empty means Empty. There should be NOTHING in your stomach when you take your Carafate. Not even vitamins or protein drink.
– Carafate can clear up the ulcerations and fully heal them, but they can come back if you are prone to this problem. Be aware and if at some point the burning returns, you can re-treat them.
– Carafate works locally, meaning it coats, protects, and heals what it touches. It does not work by being absorbed into the blood.

Why it is important to complete your treatment, even after you feel feel better.
Healing rates of an acute duodenal ulcer using Carafate:
you are 23% healed after using it for 2 weeks
… 66% healed after using it for 4 weeks
… 95% healed after using it for 8 weeks!

Getting the timing of the dosing right can be tricky.
Download an alarm app for your phone so you know when to take it. Write out a schedule and arrange your life to work around the timing of the Carafate, so you remember to take it correctly.

Here are sample schedules for dosing every 6 hours:
at 6 am
at Noon
at 6 pm
at Midnight

or at 5 am
at 11 am
at 5pm
at 11 pm

Recap: Carafate does not work unless it can stick to the ulcer or inflammation site and it cannot adhere if the stomach is not empty. So if you want to do this one time, you have to kind of let it rule your life, at least for the course of treatment.

Take care of your body. It’s the only place you have to live!

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